United States Health Information Knowledgebase

 

05. Insurance Providers and Payers


Name:05. Insurance Providers and Payers
Type:Model View
Definition:Insurance providers include data about the organizations or individuals who may pay for a patient´s healthcare, and the relationships, demographics and identifiers of those individuals with respect to the payer. Such organizations or individuals may be health insurance plans, other payers, guarantors, parties with financial responsibility, some combination of payers or the patient directly. 2.1.2.5 INSURANCE PROVIDER This insurance provider module contains data about the entities or other individuals who may pay for a patient´s healthcare. Such entities or individuals may be health insurance plans, other payers, and guarantors, parties with financial responsibility, some combination of payers or the patient directly. This module is used to define which entity or combination of entities has any financial responsibility for a patient´s care.
Registration Authority:Health Information Technology Standards Panel
Effective Date:2009-12-17
Status:Incomplete
Administrative Attributes
Responsible Organization:Health Information Technology Standards Panel
Submitting Organization:Health Information Technology Standards Panel
Steward Organization:Health Information Technology Standards Panel
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Relationship Organization Item
is a component of HITSP HITSP C154 Data Dictionary Component January 25, 2010 Version 1.0   
Relationship Organization Item
is composed of HITSP 5.01 Group Number   
is composed of HITSP 5.02 Health Insurance Type   
is composed of HITSP 5.03 Health Plan Insurance Information Source ID   
is composed of HITSP 5.04 Health Plan Insurance Information Source Address   
is composed of HITSP 5.05 Health Plan Insurance Information Source Phone/Email/URL   
is composed of HITSP 5.06 Health Plan Insurance Information Source Name   
is composed of HITSP 5.07 Health Plan Coverage Dates   
is composed of HITSP 5.08 Member ID   
is composed of HITSP 5.09 Patient Relationship to Subscriber   
is composed of HITSP 5.10 Patient Address   
is composed of HITSP 5.11 Patient Phone/Email/URL   
is composed of HITSP 5.12 Patient Name   
is composed of HITSP 5.13 Patient Date of Birth   
is composed of HITSP 5.14 Financial Responsibility Party Type   
is composed of HITSP 5.15 Subscriber ID   
is composed of HITSP 5.16 Subscriber Address   
is composed of HITSP 5.17 Subscriber Phone/Email/URL   
is composed of HITSP 5.18 Subscriber Name   
is composed of HITSP 5.19 Subscriber Date of Birth   
is composed of HITSP 5.20 Effective Date of Financial Responsibility   
is composed of HITSP 5.21 Financial Responsibility Party Address   
is composed of HITSP 5.22 Financial Responsibility Party Phone/Email/URL   
is composed of HITSP 5.23 Financial Responsibility Party Name   
is composed of HITSP 5.24 Health Plan Name   
is composed of HITSP 5.25 Insurance Company Name   
is composed of HITSP 5.26 Advanced Beneficiary Notice   
Relationship Organization Item
is composed of HITSP Guarantor Information Compare these items   
is composed of HITSP Health Plan Compare these items   
older or newer version of HITSP Insurance Providers and Payers Compare these items   
is composed of HITSP Subscriber Information Compare these items   
Relationship Organization Item
is composed of HITSP Financially Responsible Party Type_VD   
is composed of HITSP Health Insurance Type_VD   
is composed of HITSP Subscriber Relationship_VD   
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